eMJA: In other journals - 17 February 2003

mja.com.au | The Medical Journal of Australia

In Other Journals

17 February 2003

Football fan fatalities

When Argentina beat England in a penalty shoot out in the 1/8th finals of the 1998 World Cup, the English fans were heartsick — some of them literally! A recent survey of the English Department of Health’s health episodes statistics database examined hospital admissions on the day of and the two days after each of England’s four 1998 World Cup matches. The month before the matches as well as the same periods in 1997 and 1999 were used for comparison. The Cup matches were not associated with any change in admissions for stroke, road traffic injuries or deliberate self-harm, and there was no significant difference in the number of acute myocardial infarctions (AMIs) after England’s first-round games (two wins and a loss). The period following the fateful game with Argentina, however, was associated with a 25% increase in admissions for AMI, suggesting that intense emotional response to the suspenseful game may have taken its toll on some fans.

BMJ 2002; 325:1439-1442

Breast risk clarified

The finding of atypical lobular hyperplasia (ALH) on breast biopsy has long been identified as a risk indicator for breast cancer, but it was thought that both breasts were equally at risk in women with the condition. Not so, say British researchers whose study shows that the breast in which ALH has been diagnosed is at much higher risk of developing invasive cancer than the other breast. Of 252 women who had breast biopsies showing ALH between 1950 and 1985, 50 (20%) developed invasive breast cancer: 34 in the breast with ALH, 12 in the other breast, two bilateral, and in two the side was not known. Thus, the breast with ALH was three times more likely than the other breast to develop cancer. The finding is of particular importance to women who are considering preventive breast surgery.

Lancet 2002; 361: 125-129

Always with us?

Debate continues about whether autism is actually on the increase or whether the disorder is simply becoming more likely to be recognised. Researchers in Atlanta, USA, used the records of the Centers for Disease Control and Prevention’s Metropolitan Atlanta Developmental Disabilities Surveillance Program to identify possible cases of autism in children aged 3–10 years in the city. Experts then reviewed the children’s medical and educational records and used DSM-IV criteria to determine which children displayed behaviours consistent with autistic disorder, pervasive developmental disorder — not otherwise specified, or Asperger disorder. They identified 987 children, giving a prevalence for autism of 3.4/1000 children, with a male to female ratio of 4:1. The prevalence rose between the ages of three and five years, fell after age eight, and was similar in all racial groups. It was much higher than that reported in studies conducted 10–20 years ago, but was consistent with more recent studies in the United States and the United Kingdom.

JAMA 2003; 289: 49-55

Weight of the world

In our part of the world, weight loss is on almost everyone’s agenda, from individuals to drug companies and public policy planners. Researchers from the Netherlands, however, provide further evidence for the growing international call for urgent measures to prevent obesity. In an analysis of data from 3457 participants in the Framingham Heart Study who were aged 30–49 in 1948, they found an association between overweight or obesity at age 40 and decreased life expectancy, regardless of weight in later years. Non-smokers lost an average of just over three years if they were overweight (body mass index [BMI] 25–29.9 kg/m²), and 7.1 years (women) and 5.8 years (men) if they were obese (BMI >30 kg/m²). Obese smokers lived 13–14 years less than their non-smoking, normal-weight peers. Although the applicability of this 50-year-old cohort is uncertain in today’s populations, the results suggest that identifying and treating obesity in middle-age may be “missing the boat” and that prevention should be a public health priority.

Ann Intern Med 2003; 138: 24-32

Victims of fashion

Australian commentators have complained about the current trend for wearing “hipster” pants, with much of the distress centred around obligatory glimpses of unsightly back bulges, belly buttons and even pubic hair. One Canadian physician, however, has reported the phenomenon of “hiphuggers’ tingly thighs”. He describes three young, mildly obese women who presented with tingling or burning of the lateral aspect of the thigh due to compression of the lateral femoral cutaneous nerve (meralgia paraesthetica). Apparently tight hipsters can cause compression of this nerve as it passes under the inguinal ligament. The cure? Avoid the offending garments and wear loose-fitting dresses!

CMAJ 2003; 168: 16

mja.com.au | The Medical Journal of Australia

→eMJA Home →More from this issue of the MJA →MJA Archives